Mentally Fit

Workouts at the brain gym.

We humans are the only animals whose brains are known to atrophy as we grow older.

Construction by Stephen Doyle / Photograph by Grant Cornett

Do I seem smarter than I did a few weeks ago? Since then, I’ve spent many hours in front of my computer, challenged by crucially important questions, like which two butterflies of the five that flickered onscreen for seventy-nine milliseconds were the matching pair, whether the ripples that rippled across the little magenta square went this way or that way, and how many more drills I must complete before I’m smart enough to date Harold Bloom. Remember when we called these sorts of activity video games and yelled at our kids for playing them? Now we refer to them as brain exercises, and we hope and trust that our digital exertions will make us as mentally agile as teen-agers wielding M27 assault rifles in Call of Duty: Black Ops II.

Teen-agers, I said—not twenty-seven-year-olds. That’s because most neuroscientists believe that by our late twenties the speed of our mental processing has begun to ebb, and so has our attention prowess and our working memory—i.e., the scratch pad in our minds that allows us to remember information long enough to calculate the tip on the taxi fare or . . . wait, what was I saying? While it is consoling that our vocabulary improves over the years, and that we oldsters are better at big-picture thinking and are more empathetic, still, by the advanced age of twenty there is a very good chance that our prefrontal cortex (the brains of the brain, responsible for problem-solving, decision-making, and complex thought) has already begun to shrink. We humans, by the way, are the only animals whose brains are known to atrophy as we grow older, and—yay, us again—we are also sui generis in suffering from Alzheimer’s disease. As distinctions go, this may not be as auspicious as, say, the opposable thumb. Nor is it necessarily the first chapter of a story that ends with being found wandering through Central Park in your pajamas. I’m also not guaranteeing that this might not happen to you. At an Alzheimer’s Association conference in Boston last week, researchers described a newly coined condition called “subjective cognitive decline.” According to a front-page article in the Times about these ominous findings, “People with more concerns about memory and organizing ability were more likely to have amyloid, a key Alzheimer’s-related protein, in their brains.” For the time being, there is nothing we can do about the amyloids, but in the past few years scientists and entrepreneurs have been claiming that there are measures one can take to minimize, slow down, or even reverse cognitive decline. With my fingers crossed, I travelled around the country to meet some of these authorities and find out how I could turbocharge my brain.

As recently as a few decades ago, most biologists thought that the brain was fully formed during childhood and, like a photograph after it’s been developed, was doomed to degrade thereafter, with neurons (nerve cells) fading like pigment on paper until you succumbed to senility. Today, we regard Alzheimer’s and other dementias as diseases, rather than as a consequence of normal aging. Moreover, we now consider the brain to be as labile as a digital image in the hands of a Photoshop fiend. The three-pound, pinkish-gray wrinkly guck in your skull contains about a hundred billion neurons. Each neuron can hook up with up to ten thousand others; hence, there are at least a hundred trillion neural connections in your brain, which is more than there are stars in the Milky Way galaxy. Not only does the brain have a lifelong ability to create new neurons; like a government with an unlimited highway budget, it has an endless capacity to build new roadways. Networks of linked neurons communicate chemically and electrically encoded data to one another (Hey, neuron, the keys are on the table) at junctures called synapses. Fresh neural trails are generated whenever we experience something new—learn the tango, try a liverwurst canapé, take a different route to work. Repeat the activity and the pathway will be reinforced. This is why London cabbies, whose job requires them to memorize a mesh of twenty-five thousand streets and thousands of landmarks, were found to have larger hippocampi than the city’s bus drivers, who are responsible for learning only a few routes. (The hippocampus plays a major role in memory.) The ability of the brain to establish new connections is called plasticity, and brain-fitness exercises are predicated on this mechanism. Working out has also been shown to revamp the brain and prevent it from shrinking. That’s enough science for now. Let’s get back to me.

Although the combination to my junior-high-school locker seems to be indelibly lodged in some handy nook of my temporal lobe, right next to Motown song lyrics, could it be that elsewhere in my head not everything is shipshape? It’s a pretty regular occurrence for me to leave my reading glasses God knows where or lose my train of thought or have trouble recalling the word “phlogiston”—and, egads, what happened to all that stuff I used to know about Charlemagne’s in-laws? In my darkest moments, I imagine that my friends are humoring me when they insist that their amnesiac lapses are no less alarming than mine. (“Have you ever squeezed toothpaste onto your contact lenses?” a friend asked triumphantly.) Am I, like so many of my gang, just another one of the “worried well”? (A 2011 survey found that baby boomers were more afraid of losing their memory than of death.) Should I get out a crossword? Learn to play bridge? Chew gum? Take a nap? Drink more coffee? Eat blueberries? Give up tofu? There are studies that tout the rejuvenating benefits that each of these undertakings has on the brain. What to do?

For starters, I visited the Cottage Center for Brain Fitness, in Santa Barbara, which is referred to as a “brain shop” by its founder and medical director, Kenneth Kosik. This establishment, set in a bungalow decorated with clients’ artwork, aims to reset or, at least, stall the cognitive-countdown clock in order to reduce your risk of decline, through a comprehensive program that includes exercise, physical therapy, massage, nutrition counselling, life coaching, software games, lectures, and other activities you might find at, say, senior-citizen day camp (cholesterol war, anyone?). Arriving in time for the dance-movement class, I joined a small circle of attendees as the instructor guided us through relaxation exercises (“We’ll just close our eyes and send our awareness to different parts of our bodies”) and games (“I’m going to make a shape with my whole body, and then I’ll turn to Sandy, whose job will be to copy the shape with her body”). There were three clients, ages sixty-eight, eighty-eight, and ninety. Kosik, a sixty-two-year-old with baby-blue eyes and thinning hair, told me that he’d like to attract more people in their forties and fifties, which he regards as the optimal age for thwarting cerebral enfeeblement. Before I undergo a few neuropsychological tests, administered by the center’s integrative therapist, permit me another science-y interlude to explain how the brain is able to countervail the effects of aging—to some extent, and for only a limited period of time.

The notion that we can affect the resilience of our brain by investing in it early on, banking mental health as if it were a 401(k)—to borrow an analogy from Sherrie All, another psychologist I met with—hinges on the widely accepted theories of brain reserve and cognitive reserve. Kosik explained these two kindred concepts to me during a rapid discourse that he called “The History of Alzheimer’s in Thirty Seconds,” which lasted about half an hour. Here’s the short version: In 1988, several autopsies of elderly people revealed that, despite the presence in their brains of pathologies associated with Alzheimer’s disease, these individuals, in life, had displayed no symptoms of dementia. It has been hypothesized that they’d been buffered from the effects of the disease by the extra neuronal capacity that they had been born with (brain reserve) or that had accrued through years of intellectual and physical pursuits (cognitive reserve). Similarly, a study of six hundred and seventy-eight elderly nuns analyzed essays they’d written in their twenties and found that the sisters who had used the most linguistically complex sentences tended to have the lowest incidence of Alzheimer’s, which is why I’ve added this unnecessary subordinate clause even though it’s been a long time since I was in my twenties. How is it that certain minds seem able to forestall senescence despite genetic programming? The damage to the brain caused by Alzheimer’s can be compared to traffic jams caused by tractor-trailer accidents. Someone who has a robust neural network can find ways around these obstructions using back roads.

With this in mind, I was happy to hear that I aced the tests I took. I think you would, too, if, for instance, you know the answer to the question “What city are we in?,” can figure out what a banana and an orange have in common, copy a drawing of a cube, and have no trouble recognizing a rhinoceros. On the other hand, as Kosik said during my evaluation, compared with the diagnostic acumen of computer-based testing, “every pencil-and-paper test is a blunt instrument.” Kosik is part of a team that is developing an Alzheimer’s-prevention drug now being tested on members of an extended family in the vicinity of Medellín, Colombia, whose mutated genes doom them to an especially virulent form of dementia that can show up in their brains as early as age thirty. In most cases, he said, heredity is not so deterministic. “Everyone can name at least six reasons why you should eat sensibly, reduce stress, and exercise,” Kosik said. “Now there is a seventh.” If you are middle-aged, managing your blood pressure, according to Kosik, is probably the best measure you can take to minimize your risk of vascular dementia—the second most prevalent type of dementia, after Alzheimer’s. Kosik is also emphatic about the benefits of social interaction, citing a study that found that isolation among seniors was linked with cognitive impairment. (Party on!) “I’m sure some of my colleagues in Boston”—Kosik was previously at Harvard and Tufts—“would look at this as a fringe operation, a storefront with walnuts and incense,” he said of the Cottage Center. “On the other hand,” he continued, “we can wait for science to come up with a cure or we can jump in and try to create an atmosphere that is conducive to good brain health.”

Next, I stopped at the Brain Health Center, in San Francisco. I had to reschedule my phone appointment with Louisa Parks, a clinical neuropsychologist and brain coach, who teaches memory tricks to patients with cognitive deficits, because I forgot to call her. Remembering to remember is called prospective memory, and one technique Parks recommends for triggering it is to link the item that’s threatening to vaporize in your mind with another that’s more rooted in your consciousness. That is to say, put your house keys in the refrigerator next to your corned-beef sandwich (and then remember which to eat). Parks leads six-week sessions with groups of clients, offering them tactics like these.

Parks hypothesized that, while I don’t have a recall problem, I could brush up on focussing my attention. Before I could celebrate, she said that pretty much everyone has an attention problem, especially these days, when—stop checking your e-mail!—there are so many distractions. The act of remembering, she said, has three stages: encoding, storage, and retrieval. The second we can’t control, and the third, barring a stroke or a neurological disease, depends on the first. If the proper information isn’t inputted into the machine, as it were, then good luck getting it outputted. Parks recommends mindfulness training. This is a variation on Buddhist meditation, in which the practitioner learns to pay attention selectively and, as she put it, “to remain in the present, rather than to wallow and worry about the past and catastrophize the future.” She guided me through an exercise that involved devoting my thoughts exclusively to my breath (not daydreaming about whether I’m out of paper towels). If one masters single-minded breathing, a theory has it, one will also become adept at concentrating on non-respiratory concerns. I am not good at breathing. Many years ago, at a spa, I was yelled at for not breathing correctly, but that’s another story.

Guess what else I’m bad at? Anxiety management. This was more or less the conclusion of the online Brain Fitness Check-up I underwent, which was designed by a Washington, D.C.-based company called NeoCORTA. The checkup consists of a very long questionnaire that takes about half an hour to complete. Most of the questions are in the form of statements that you must respond to on a scale of “very poor” to “very good.” For example: “My ability to remember grocery items without consulting a list is . . . ,” “My ability to follow a map to a new location is . . .” There are also questions you’ve been asked a million times before on forms, like how many servings of fruits and vegetables do you eat per day?, and others that I bet you will encounter for the first time, such as “I notice and hear sounds around me, just as others do.” Based on my answers, NeoCORTA recommended a Personal Action Plan, whose suggested activities included Tai Chi and volunteer work. The NeoCORTA Web site claims that the company’s test is “the quickest, easiest way to begin the brain fitness journey.” (How I wish that sentence had ended with “journey to the Amalfi Coast.”)

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Why is being a nervous wreck so bad for the brain? To find out, I spent a calming day at the Chicago Center for Cognitive Wellness, a two-room suite in a building in Evanston, Illinois, above the World of Beer. The clinic, founded by a psychologist named Sherrie All, and jointly run by her and her associate, Jennifer Medina, offers one-on-one cognitive-wellness coaching, in which stress reduction plays a big part. (Fermented beverages are not involved.) “Americans are fat and sedentary, and we’re stressed out, and none of that is good for our brains,” All said. “That’s why I developed my holistic approach.” All hopes to open a chain of brain spas, a hard venture to pull off, because most insurance companies don’t cover this type of preventive care, and because many people are not aware of the potential benefits. “We get discouraged about the market, but fifty or sixty years ago there wasn’t a physical-fitness industry,” she said.

Under her supervision, I took another battery of tests. If the rate at which I’m able to strike the computer space bar during a thirty-second interval is a meaningful measure, then I could use a little remedial help on my motor tapping skills. (So long, drumming career.) After I’d repeatedly pressed the left arrow and the right arrow, depending on whether an onscreen dot turned red or green, and after I recognized the emotions on a series of line-drawn faces (I confused “disgust” and “anger”), and after I pressed the space bar whenever I saw the word “press” if the letters were green and not if the letters were red, Medina and I met in the therapy room (brown sofa, brown rug), where we talked about the evolutionary reasons for stress, which she referred to as Dr. Evil, and how it affects our memories. To recap: sometimes stress is good. As anyone who has ever had to fend off a woolly-mammoth attack will tell you, the hormonal cascade that is generated in a state of emergency by your body’s sympathetic nervous system—the so-called fight-or-flight response—empowers you to act with preternatural energy and vigilance. “Fast-forward hundreds of thousands of years, and we don’t have to fight predators for our food,” Medina said. We still have a fight-or-flight response, “but it’s not purposeful when you’re standing in line waiting for the clerk to hurry up.” When stress is long-lasting, it is like using a nuclear reactor to operate your hair dryer. After being persistently bombarded by cortisol, neurons eventually wither and your hippocampus shrivels. The end.

Well, not so fast, says the team at Heartmath, a company that sells stress-reducing devices that are designed to teach you Inner Balance™, give you a more positive outlook, increase mental clarity, and improve your memory. All you have to do is clamp a pulse sensor to your ear and think happy thoughts. The product that I sampled is called emWave Desktop. This is a software program that translates information about your heart rate as it is being collected by the ear thingamajig, and displays the data on your computer in the form of animated graphs, sine curves, and inspirational scenes of plants sprouting in a garden, gold filling a pot at the end of a rainbow, an oversized child radiating psychedelically colored light beams toward planet Earth, and the like. It is a G.P.S. for the soul. The goal is to achieve maximum coherence. According to Rollin McCraty, the director of research at Heartmath’s academic arm, coherence “is a state that builds resiliency—personal energy is accumulated, not wasted.” Got that? Seeking enlightenment, I spent a few hours on the phone with Gaby Boehmer, the company’s director of public relations, and Tom Beckman, a biomedical engineer by training, whose responsibilities at Heartmath include instructing health-care professionals in the use of emWave. “It is like building emotional muscle,” Boehmer told me. “When you are in a state of coherence, the heart and brain and nervous system are working synchronistically,” Beckman added. Apparently, you reach a state of heart-rhythm coherence when you’re feeling positive emotions. “The reason we focus on the heart to facilitate brain fitness is because the heart is sending more information to the brain than vice versa,” Beckman said. During my emWave tutorial, I was advised to focus on the center of my chest and reëxperience a positive feeling, by recalling, for instance, a special place or pet. The best I could do was fantasize about finishing the emWave session. It did the trick. My heart was so well behaved that the little thermometer in the corner of my screen registered green seventy-seven per cent of the time, and Beckman said, “Good job. I’m impressed with your coherence.”

To everyone who has solved today’s crossword puzzle: Sorry, but that is no guarantee that you will end up less nutty than the rest of us. Alvaro Fernandez, the C.E.O. of SharpBrains, a market-research firm concerned with brain health, told me, “Once someone has done hundreds or thousands of them, the marginal benefit tends toward zero, because it becomes just another routine, easy activity—probably a bit more stimulating and effortful than watching TV, but not enough to bring benefits other than becoming a master at crossword puzzles.” If you’re practiced enough to know that an auk is a diving seabird, it’s time to learn sign language or take up the tuba. Fernandez, like many others, recommends engaging in unfamiliar challenges. If you take this counsel to the extreme, there is neurobics, the mental-calisthenics regimen popularized by Lawrence Katz and Manning Rubin in their book “Keep Your Brain Alive: 83 Neurobic Exercises to Help Prevent Memory Loss and Increase Mental Fitness” (1999). In order to qualify as a neurobics exercise, a task must “involve one or more of your senses in a novel context” and “break a routine in an unexpected, nontrivial way.” Guess which exercise among the following was not conceived of by Katz and Rubin: shower with your eyes closed, brush your teeth with your nondominant hand, wear earplugs to your family breakfast, wear mittens while driving, turn your family photos upside down, shop at an ethnic market, eat waffles for dinner. Answer: they are all bona-fide neurobic exercises.

Staving off dotage is not cheap. According to a recent report issued by SharpBrains, the amount spent on brain fitness in 2012 was more than a billion dollars, and by 2020, it is estimated, that figure will exceed six billion dollars. Most of the merchandise is some kind of software.

Adam Gazzaley is a neuroscientist and the co-founder of Akili Interactive Labs, an outfit that is hoping to develop the first therapeutic F.D.A.-approved video games. “Brain fitness of tomorrow will be created in rooms like this,” he told me, during a tour of the neuroimaging center that he directs at the University of California, San Francisco. The Virtual Simulation room was so minimally appointed—a couple of flat screens and a few headsets with electrodes lay about—that it looked as if it had been burglarized. “We’re developing neural stimulation, including T.D.C.S.”—transcranial direct-current stimulation”—and hoping to integrate them into a multimodal approach that rewires the circuits of the brain.” In other words, the video game of the future will not only sense what is going on in your brain but also make your brain more plastic by shooting electricity through it. Remember when your mother told you not to sit too close to the TV? Now you’re part of the TV.__

I have read studies in which it was concluded that playing brain games improves your working memory, sharpens your attention, builds your fluid intelligence (the ability to solve novel problems and think logically), boosts your I.Q., rolls back the clock ten years in terms of memory performance, delays mental decline by seven years, decreases your risk of an automobile crash, revs up skills that would make you a more reliable air-traffic controller, and makes you much sexier (not really). I have also read studies that disputed each of these studies. Fernandez, of SharpBrains, told me, “If you find a game that addresses a relevant cognitive or emotional bottleneck, you can make a difference in your quality of life in ten to fifteen hours of training.”

Which to choose? To name just a few: Cogmed, Lumosity, Brain Games, Jungle Memory, CogniFit, MindSparke, MyBrainSolutions, Brain Spa, brainTivity, Brainiversity, Brain Metrix, Mind Quiz: Your Brain Coach, Brain Exercise with Dr. Kawashima, Nintendo’s Brain Age, MindHabits, NeuroNation, HAPPYneuron. There seem to be enough products to give each of your synapses its very own personal-training program. They vary in price (many are free; Lumosity is a subscription that costs fourteen dollars and ninety-five cents a month; Cogmed costs around fifteen hundred dollars, which entitles you to a five-week coach-supervised session and access to twelve games); intended customer (e.g., Dakim BrainFitness is meant for people over sixty); and purpose (some emphasize particular brain functions, such as working memory or emotional regulation; others are more all-encompassing).

I chose BrainHQ, a platform offered by Posit Science, a San Francisco company, which was one of the first to enter the brain-fitness realm. Posit was co-founded in 2003 by Michael Merzenich, a neuroscientist. The program specializes in speeding up the rate at which the user processes information, making your brain operate more like I.B.M.’s Watson supercomputer than like my laptop. “Why do you lose your memory?” Merzenich asked. “You don’t forget because the brain has forgotten to remember. You lose your memory because the brain is representing the things you are seeing and hearing and feeling less saliently. When you’re young and you see something surprising, your eyes are attracted to it. You are bright-eyed, literally. Your eyes take a series of snapshots that reveal information about what’s out there. Seventy-year-olds might not see what’s there, and if they do see it they’ll turn their whole heads and stare, instead of darting their eyes.” Merzenich went on to explain that the peripheral vision of a sixty-year-old is only three-quarters as panoramic as that of a twenty-year-old. “We want to train your eyes to be more childlike,” he continued. “We can take a person at any age and restore their sparkiness.” Merzenich told me that recent findings have shown that a Posit program similar to the one I’d be trying effectively reversed cognitive aging by eleven years, on average, after only ten hours of training. Great! If I complete the program a bunch of times, I can find out who I was in a previous life.

I trained for an hour a day over a six-week stretch (thirty minutes a day is customary, but I was on an accelerated schedule). In all, there were fifteen exercises. Some, like Target Tracker, were meant to augment attention. A number of identical jellyfish appeared onscreen, followed by a fluther of more identical jellyfish, all of them moving as if they were playing musical chairs. When they stopped, I was asked to pinpoint the original bunch. When I graduated to higher levels of the exercise, the jellyfish moved faster and became more translucent. When I beat a benchmark I’d previously set, fireworks exploded. I’m ashamed to admit how proud I felt. On the other hand, an alertness exercise, Freeze Frame, rattled me so much that I considered giving the emWave a second chance. It entailed unhesitatingly tapping the space bar sometimes and refraining from pressing the space bar at other times, depending on which photograph flitted across the screen. One of the toughest tests was Card Shark, a version of the classic n-back test, whereby the subject is presented with a sequence of items—in this case, playing cards—and asked to indicate when the current card matches the one n steps back. The n-back is a memory-building tool that has been shown to raise I.Q. Among the many tests that I genuinely liked was Recognition, a People Skills exercise in which a face, cropped at the hairline, is flashed onscreen for a few milliseconds, after which you must select the one you saw from an array of faces. As you progress in this task, the angle of the faces becomes more oblique, the number of faces in the grid increases, and the target face appears for shorter bursts—a virtual speed cocktail party, but without the crostini and the mojitos.

How did I fare over all in this self-help adventure? Judging from the series of questionnaires I filled out during the course of my training, my mood brightened, my sleep was more restful, and I felt more confident. I may also have become a bigger liar on questionnaires, but that was not evaluated. As for the exercises, my scores were higher across the board. In an e-mail summing up my progress, Merzenich wrote, “Your advances on these exercises come from brain remodeling. If we had recorded from/imaged your brain before and after training, we could have easily shown that you now have a ‘better’ (stronger, faster, more reliable, more accurate) brain.” (Wouldn’t they make dandy wallet photos?) Compared with my poky old brain, my souped-up brain, according to Merzenich, has more synapses, better wiring, stronger connections, and more forceful activity. (Doesn’t that sound like an ad for a five-thousand-dollar stereo?) He said that my enhanced brainpower should last several years, after which I could “slip back past the neurological position that you were at when you began this training.”

I’m not sure I noticed my newfound cognitive abilities in my everyday life. It’s hard to be both scientist and lab rat. On the positive side, I am slightly less troubled about the size of my hippocampus. On the negative side, why did I sprinkle NutraSweet on my broiled salmon last night? ♦

This article appears in the print edition of the July 29, 2013, issue.

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